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      Comparison of high-resolution Scheimpflug and high-frequency ultrasound biomicroscopy to anterior-segment OCT corneal thickness measurements

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          Abstract

          Background

          The purpose of this study was to compare and correlate central corneal thickness in healthy, nonoperated eyes with three advanced anterior-segment imaging systems: a high-resolution Scheimpflug tomography camera (Oculyzer II), a spectral-domain anterior-segment optical coherence tomography (AS-OCT) system, and a high-frequency ultrasound biomicroscopy (HF-UBM) system.

          Methods

          Fifty eyes randomly selected from 50 patients were included in the study. Inclusion criteria were healthy, nonoperated eyes examined consecutively by the same examiner. Corneal imaging was performed by three different methods, ie, Oculyzer II, spectral-domain AS-OCT, and FH-UBM. Central corneal thickness measurements were compared using scatter diagrams, Bland-Altman plots (with bias and 95% confidence intervals), and two-paired analysis.

          Results

          The coefficient of determination ( r 2) between the Oculyzer II and AS-OCT measurements was 0.895. Likewise, the coefficient was 0.893 between the Oculyzer II and HF-UBM and 0.830 between the AS-OCT and HF-UBM. The trend line coefficients of linearity were 0.925 between the Oculyzer II and the AS-OCT, 1.006 between the Oculyzer II and HF-UBM, and 0.841 between the AS-OCT and HF-UBM. The differences in average corneal thickness between the three pairs of CCT measurements were −6.86 μm between the Oculyzer II and HF-UBM, −12.20 μm between the AS-OCT and Oculyzer II, and +19.06 μm between the HF-UBM and AS-OCT.

          Conclusion

          The three methods used for corneal thickness measurement are highly correlated. Compared with the Scheimplug and ultrasound devices, the AS-OCT appears to report a more accurate, but overally thinner corneal pachymetry.

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          Most cited references30

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          Clinical use of ultrasound biomicroscopy.

          The authors have developed a method of obtaining images of cross-sections of the intact anterior globe at microscopic resolution. High-frequency ultrasound transducers (50-100 MHz) have been developed and incorporated into a clinical B-scan device capable of producing images in the living human eye to a depth of approximately 4 mm at an axial and lateral resolution approaching 20 microns. Clinical use of this instrument is no more difficult than conventional immersion ultrasonography. The authors' results in a series of 14 clinical cases have shown that this method can provide information unavailable from any other imaging technique. Anterior segment tumors difficult to define with conventional ultrasound can be measured and the extent of invasion determined. Differentiation of tissue on the basis of internal acoustic characteristics is aided by the very fine backscatter speckle patterns at these frequencies. Pathology behind anterior segment opacities can be imaged in detail and the ability to image angle structures in cross-section allows a new quantitative method of gonioscopy. The ability to define the relationship of the iris, posterior chamber, zonules, ciliary body, and lens is potentially helpful in understanding mechanisms of glaucoma. Ocular structures can be measured with increased accuracy. Clinical ultrasound biomicroscopy (UBM) has shown significant potential as an aid in diagnoses of ocular disease.
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            Spectral-domain optical coherence tomography: a comparison of modern high-resolution retinal imaging systems.

            To provide a review of commercially available spectral-domain optical coherence tomography (SD OCT) systems in clinical ophthalmology. Perspective. Review of current manufacturer information, selected articles from the literature, and the authors' clinical experience. Because the premise of SD OCT technology is the nonproprietary mathematical formula of Fourier transformation, 9 different SD OCT systems currently are or soon will be commercially available. Also demonstrated are Cirrus en face C-scan visualization of photoreceptor attenuation resulting from acute zonal occult outer retinopathy and Spectral OCT/scanning laser ophthalmoscopy microperimetric analysis of a macular caldera lesion resulting from North Carolina macular dystrophy. Advances in high-resolution imaging of the anterior and posterior segment have revealed new in vivo details of anatomic, physiologic, and pathologic data for the practice of ophthalmology. Compared with time-domain OCT, SD OCT tends to derive increased retinal thickness and decreased nerve fiber layer thickness measurements. This is likely because of increased depth of resolution and greater volume of data acquired with each scan. Interdevice comparison is not practical because of differences in individual segment boundary algorithms. Improvements in photoreceptor inner segment-outer segment layer visualization should aid our understanding of visual dysfunction in a variety of retinal pathologic features. As the technology develops, SD OCT will continue to provide new insights about ocular structure and disease. Copyright 2010 Elsevier Inc. All rights reserved.
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              Between-eye asymmetry in keratoconus.

              To report baseline differences between eyes on key variables in the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study cohort compared with a retrospectively assembled group of myopic contact lens wearers without ocular disease. A total of 1,079 keratoconus patients who had not undergone a penetrating keratoplasty in either eye before their baseline visit were enrolled and examined at baseline. Records from 330 contact lens-wearing myopes were reviewed. Corneal curvature (keratometry), visual acuity, refractive error (manifest refraction), and corneal scarring were measured. The mean differences between keratoconic eyes are as follows (better eye-worse eye for each variable, separately). Flat keratometry: -3.59 +/-4.46 D and steep keratometry: -4.35 +/-4.41 D; high-contrast best-corrected visual acuity: 7.30 +/-6.83 letters; low-contrast best-corrected visual acuity: 8.53 +/-7.51 letters; high-contrast entrance visual acuity: 9.03 +/-8.40 letters; low-contrast entrance visual acuity: 9.43 +/-7.88 letters; spherical equivalent refractive error: 3.15 +/-3.84 D; and refractive cylinder power 1.55 +/-1.42 D. Twenty-one percent of the keratoconus patients had corneal scarring in only one eye. There is an association between patient-reported unilateral eye rubbing and greater asymmetry in corneal curvature, and between a history of unilateral eye trauma and greater asymmetry in corneal curvature and refractive error, with the rubbed/traumatized eye being the steeper eye most of the time. Keratoconus is asymmetric in the CLEK Study sample.
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                Author and article information

                Journal
                Clin Ophthalmol
                Clin Ophthalmol
                Clinical Ophthalmology
                Clinical Ophthalmology (Auckland, N.Z.)
                Dove Medical Press
                1177-5467
                1177-5483
                2013
                2013
                20 November 2013
                : 7
                : 2239-2247
                Affiliations
                [1 ]Laservision.gr Eye Institute, Athens, Greece
                [2 ]New York University Medical School, New York, NY, USA
                Author notes
                Correspondence: A John Kanellopoulos, Laservision.gr Eye Institute, 17 Tsocha Street, Athens, Greece 11521, Tel +30 21 0747 2777, Fax +30 21 0747 2789, Email ajk@ 123456brilliantvision.com
                Article
                opth-7-2239
                10.2147/OPTH.S53718
                3838761
                24348011
                96de0ab7-1a8d-4940-8d39-2f1d74948acd
                © 2013 Kanellopoulos and Asimellis. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Ophthalmology & Optometry
                optical coherence tomography,high-frequency ultrasound biomicroscopy,anterior eye segment,high-resolution pentacam,corneal thickness

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